More Hospital Groups Critique State Budget, Warn Of Consequences

The state's hospital association and a second major hospital group on Wednesday joined Hartford HealthCare in warning that the new state budget, if left unchanged, will hurt health care in Connecticut.

It's a bleak forecast: fewer hospital workers, fewer medical services, a conundrum for the poor as they struggle to get medical care with Medicaid coverage that doesn't cover the cost of clinical services.

The Connecticut Hospital Association and Hartford HealthCare hope residents will contact their legislators about the budget before a special session to dissuade them from reducing Medicaid rates and increasing taxes on hospitals.

On Tuesday, Hartford HealthCare, parent company of Hartford Hospital and four others, issued a strongly worded statement against the budget and the lawmakers who passed it. On Wednesday, the Connecticut Hospital Association and Yale-New Haven Health System followed up with critiques of their own.

"When the state goes about actually reducing funding to hospitals, they're actually reducing our ability to take care of the folks who all of us would say are most vulnerable and have the least access to care," said Stephen Frayne, senior vice president of health policy for the Connecticut Hospital Association.

Hartford HealthCare said it will receive $100 million less in state payments as a result of the state's two-year budget...

HARTFORD — The parent company of Hartford Hospital warned of "significant" job cuts and fewer services if the state's budget isn't changed in the legislature's special session.

Hartford HealthCare said it will receive $100 million less in state payments as a result of the state's two-year budget...

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The state budget includes a higher tax on hospitals and a lower state contribution on some Medicaid rates, which means lower reimbursement rates for clinicians.

"Embedded within the Medicaid cuts, the Medicaid reimbursement for an X-ray is down 57 percent as a result of this," said Rocco Orlando, chief medical officer at Hartford HealthCare. "That means, if you're a private radiology group, you lose money every time you take an X-ray, do a CT, do an MRI. They can't afford to do this. … So, they will stop seeing Medicaid."

The result, he said, is a delay in diagnosis of medical problems for low-income individuals and families, and a delay in care.

Last week, some of the state's largest corporations roared loudly as the details of a two-year budget passed by the General Assembly came into view. In an effort to balance the state budget, the legislature needed more revenue — and while it went to many places to find it, several of the biggest...

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"The patient will present with their illness, but further in the course of the disease, generally to an emergency department, [which results in] more costly care for them, and, most important, a worse outcome," Orlando said.

David Dearborn, a spokesman for the state Department of Social Services, pointed out that Connecticut has been a national leader in adding more primary-care providers to its Medicaid program. Medicaid rates for primary-care physicians have increased to help boost participation from 1,622 clinicians in January 2012 to 3,589 in January 2015, Dearborn said.

"In addition, we're raising the payment rates for outpatient mental health clinics, which will also help prevent unnecessary emergency department visits as more people have access to community services," Dearborn said via email.

"Medicaid payment rates vary, depending on the type of service. Primary care (a foundation of the Affordable Care Act) is one of the strongest facets of public coverage in Connecticut," Dearborn said.

One of the other criticisms hospitals have of the state budget's effects on hospitals is jobs.

"Hospital jobs are good jobs," Connecticut Hospital Association CEO Jennifer Jackson said. "And they provide meaningful, well-paying work for a community. And when you continue to cut, it just has a ripple effect, in that hospitals are going to have to reduce jobs."

Additionally, hospitals are going to cut services as a result of the state budget, according to the hospital association, Yale-New Haven Health System and Hartford HealthCare.

"We are clearly looking at how and where we provide access to services throughout the region and how we can potentially consolidate some of those services. So, I think that creates access issues," said Vin Petrini, senior vice president of public affairs for Yale-New Haven Health System.

In the past, hospitals would make up their losses on low Medicaid rates by negotiating higher rates with private health insurers, such as Aetna, Anthem, Cigna, ConnectiCare and UnitedHealthcare. That's getting more difficult to do as insurers resist the "cost shift."

"The problem is that the hospitals are finding it much more difficult to shift those costs, and it's creating an enormous stress on those hospitals that are charged with providing coverage to [Medicaid] patients throughout the state," Petrini said.

However, the state Department of Social Services said Wednesday more people are insured as a result of the Affordable Care Act and the state insurance exchange, Access Health CT.

"With more people insured through the health insurance exchange and the rate of uninsured CT residents going down overall, hospitals may see tens of thousands of more insured patients, across both private and public coverage," Dearborn said via email.

"The payment rates vary, depending on insurer, but the fact is that as more CT residents have health coverage overall, the more revenue sources hospitals see and the less uncompensated care they have to provide," he said.